Varicose vein symptoms & treatment 

If you're in pain or discomfort, our vascular specialists can discuss varicose veins treatment options with you. 

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If you are suffering from varicose veins, you'll likely see large veins that are purple and bulging in appearance on your legs and feet. Any vein that is close to the skin's surface, referred to as superficial veins, can become varicosed. 

Veins have many one-way valves to help blood flow back to your heart. If you have varicose veins, the valves in your veins aren't working properly because they are weak or damaged. This causes blood to flow backwards and pool in the veins, making the veins stretch or twist.

You may be recommended varicose veins surgery if you are experiencing the following symptoms:

• Veins that are lumpy, bulging or twisted in appearance
• Aching, heavy and uncomfortable legs
• Swollen feet and ankles
• Burning or throbbing pain in your legs
• Muscle cramps in your legs, usually at night
• Dry, thin and itchy skin over the affected veins

Varicose vein symptoms are often worse during warm weather conditions or if you've been standing for long periods. They may improve when you walk around or if you rest and raise your legs.

Non-surgical treatments

Patients who require treatment are often advised to use compression stockings first. These stockings are specifically designed to apply gentle pressure on the legs, helping to improve blood flow and reduce swelling. They are often the first line of defence and can be used alongside other treatments.

You may also be recommended to implement some lifestyle changes, such as doing more regular exercise and elevating your legs when sitting or lying down. These can help improve circulation and alleviate symptoms like achiness and fatigue.

However, if you're still feeling discomfort or your varicose veins cause health complications, there are several different types of treatment available.

Minimally invasive procedures

• Sclerotherapy: This involves injecting a solution into the varicose vein, causing it to scar and collapse. The body then reabsorbs the vein over time. The procedure is most suitable for small and medium-sized varicose veins.
• Endovenous ablation: This technique uses heat (radiofrequency or laser) delivered through a catheter that is inserted into the vein. The heat damages the vein lining, causing it to close and seal shut. This is a common procedure for larger varicose veins.
• Mechanical phlebectomy: This outpatient procedure involves making tiny incisions and using specialised tools to remove small varicose veins near the skin’s surface. It’s often used in conjunction with other treatments.

Surgical procedures

• Vein stripping: In this traditional surgery, the doctor makes small incisions and removes the main varicose vein through these openings. While effective, it’s more invasive than other options and may require more recovery time.
• Laser surgery: This technique uses a laser beam to target and close off varicose veins. It’s a newer approach and may be used for specific vein locations.

Choosing the right treatment

The best treatment for you will depend on several factors, including the severity and location of your varicose veins, your overall health, and your preferences. It’s crucial to discuss your options with a doctor who can assess your individual situation and recommend the most suitable approach.

What are the risks and side effects of varicose vein surgery?

The risks and side effects of treatment and surgery are usually minimal. Your vascular doctor will explain the procedure to you, ensuring you're aware of every detail so you know what to expect. 

Depending on the type of varicose vein removal private procedure you have, potential side effects and risks include:

• Paraesthesia (pins and needles), usually temporary
• Tight, bruised and painful legs
• Nerve injury (usually only temporary)
• Blood clots in other leg veins
• Headaches
• Changes to skin colour (brown patches over the treated areas)
• Fainting
• Temporary vision problems

How do I prepare for varicose vein removal?

Your consultant will let you know what type of treatment is best for you, what's involved in the procedure and how to prepare. You may need to have a general anaesthetic for your procedure, so your consultant will let you know how long you should avoid eating and drinking beforehand.

You must tell your doctor about any prescription or over-the-counter medications you currently take, as you may be asked to stop these temporarily before the procedure. This is because some can cause heavy bleeding during private varicose vein treatment.

You should also arrange to have someone to take you home after your surgery as a general anaesthetic can make you drowsy and unable to drive for several hours.

What happens during varicose vein surgery?

Thermal endovenous ablation

This procedure involves heating the varicose vein to collapse it and seal it shut, allowing your blood to naturally redirect to one of your healthy veins. The heating process can be done via radiofrequency, known as radiofrequency ablation, or using a small laser, known as endovenous laser treatment for varicose veins. 

Under a local anaesthetic, a narrow tube (catheter) is inserted into the vein using an ultrasound scan to guide it to the correct location. A probe or small laser is then guided through the catheter to reach and heat the varicose vein with a short burst of energy. 

Sclerotherapy

Sclerotherapy involves the injection of foam into the veins. This foam is used to scar the veins, causing them to seal shut. This procedure will be offered to you if endothermal ablation treatment is deemed unsuitable. However, if you've previously suffered from deep vein thrombosis, sclerotherapy won't be considered. 

An ultrasound scan is used to guide the injection to the vein. More than one vein can be treated in the same session. The procedure is typically carried out under local anaesthetic. 

Your varicose veins should begin to fade a few weeks after the procedure. However, you may require this treatment more than once to ensure the veins fade completely. 

Ligation and stripping

Ligation and stripping involves tying up the vein in the affected area and removing it. Your surgeon will make two small incisions. The first is made near your groin at the top of the varicose vein. The second is a smaller cut further down your leg at the knee where the top of the vein is tied and sealed.

A thin wire is passed through the bottom of the vein and carefully pulled out and removed through the lower cut at the knee. Your blood flow will not be affected as veins deep within your leg will take over the role of the damaged veins. 

What happens post-surgery?

Depending on what type of procedure you have, you may have to wear compression stockings for a week or two to prevent blood clots in the leg. You'll likely experience some pain for a couple of weeks after your treatment too. 

Your consultant will let you know what to expect and when you can get back to your routine. They'll also let you know how your treated varicose veins might look in the weeks after your procedure.

How can I relieve varicose vein pain?

Ahead of your treatment, you may be able to temporarily relieve symptoms by walking around or resting and raising your legs. 

Placing your feet up on a table, stretching them up a wall or lying down in bed can encourage blood flow in your lower body to circulate towards the heart. That way, the venous valves can function more effectively. You can reduce swelling and ease pain by elevating your legs for at least 15 minutes each time. 

Small exercises each day could also be helpful in varicose vein pain relief. Flex your feet regularly and stretch your calf muscles a few times a day. If you have a job that requires sitting for long periods, you should try to change your position at least every 30 minutes.